pancreas transplantation

..organ donors are processed by the AOC per year and 10-25 pancreases per year have been used for whole pancreas transplantation during the last 10 years. Accordingly, a large pool of pancreases is available for the proposed studies...

..FDA approval for prophylaxis of CMV infection in high risk patients undergoing kidney, heart and kidney-pancreas transplantation at a dose of 900mg per day...

DESCRIPTION (provided by applicant): Pancreatic islet transplantation is less efficient than whole organ pancreas transplantation in reversing the hyperglycemia of diabetes...

DESCRIPTION (provided by applicant): Pancreatic islet transplantation is less efficient than whole organ pancreas transplantation in reversing the hyperglycemia of diabetes...

..We have assembled a team of investigators with experience in pancreas transplantation (Burke, Miami) and the immunology of T1D (Pugliese, Miami; Nepom, Seattle) to study the key immunological ..

..success rate, as measured by insulin independence > 1 year post transplant, is comparable to whole organ pancreas transplantation. The major barrier for routine clinical adoption of the Protocol is the poor recovery of islets from ..

..investigator of this proposal, has successfully performed the largest number of living related segmental pancreas transplantation and islet autotransplantation worldwide...

..gold standard for assessing small fiber damage), and is able to demonstrate early nerve repair after pancreas transplantation. We now propose to establish CCM as a valid surrogate for human DPN through a set of coordinated studies...

..transplantation will represent a major advance to the field, placing the procedure on a par with whole-pancreas transplantation in regards to donor utilization, but without the associated risk of major morbidity...

..Both diseases can be cured by replacement of pancreatic beta cells by pancreas transplantation but this requires life long immunosuppression and there are far fewer organ donors than people with ..

..purified HK-1 protects mice from acute CCI4-induced liver cell injury and augments the success of fetal pancreas transplantation. In phase I we will express the cDNA for HK-1 and purify sufficient quantities of protein for biological ..

..This abstract is not available...

..CONCLUSIONS: There was no evidence that HLA matching was associated with improved kidney or pancreas survival. However, a higher rate of acute rejection was observed with poor HLA match, which may impact long-term survival...

..Also, serum creatinine was highest in late rejectors. CONCLUSION: Tacrolimus-based immunosuppressive therapy demonstrates significant advantages over cyclosporin-ME in terms of the severity of acute rejection in SPK transplant patients...

..In view of the potential risk of hypertension, antihypertensive strategies should be implemented for all patients...

..5% in group I and 31.9% in group II) after SPK. Only 6.9% (group I) and 6.4% (group II) of the patients received antibodies for rejection treatment...

..3%, 94.6%, and 83.8% and 5-year values, 91.7%, 89.2%, and 78.7%, respectively. In conclusion, these results are similar to the most recent UNOS/IPTR reports, leading us to consider our experience with SPKT very positive...

BACKGROUND: Pancreas transplantation (PT) has proved effective but it is associated with a high risk of surgical complications and technical failure. Duct management and venous drainage are identified as major issues...

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..Even after KTX with graft failure, diabetic patients suffering from renal disease can be re-transplanted successfully with SPK...

..36 vs. 1.67 g/day; P = 0.007). CONCLUSION: These findings support the use of tacrolimus therapy for uremic patients with type 1 diabetes who are undergoing SPK transplantation...

..Fewer repeat laparotomies translate into improved pancreas and kidney graft survival...

..Alemtuzumab induction followed by steroid-free maintenance therapy with a tacrolimus/sirolimus-based immunosuppression regimen provided an effective, safe and cost-conscious approach to SPK transplantation...

..It also provided superior pancreas survival and reduced the risk of pancreas graft thrombosis...

..The potential beneficial long-term impact of steroid avoidance will require further study...

The aim of this study was to evaluate the outcome of simultaneous kidney pancreas transplantation (SKPT) by various surgical techniques...

..This strategy of overcoming the cross-match barriers in living donation may offer a chance of successful transplantation to highly sensitized candidates for SPKT, for whom cadaveric transplant is difficult to achieve...

..b>Pancreas transplantation represents an effective treatment worldwide and in Japan, due to the availability of CyA or tacrolimus in ..

b>Pancreas transplantation started in December 1966 at the University of Minnesota but the number of transplants eventually increased in the early 1980s for two main reasons: the refinement in surgical techniques and the advent of ..

..In this article we review the evolution of the pancreas transplant from its beginnings to its present state...

..CONCLUSIONS: A long-term survey of corticosteroid withdrawal in SPK transplantation with multifactorial analyses is necessary to confirm these early results and to evaluate the positive effects on glucose metabolism and hypertension...

..Tacrolimus was the preferred immunosuppressive agent, resulting in fewer cases of pancreas graft loss and drug discontinuation compared with cyclosporin-ME...

..CONCLUSIONS: These results indicate that relatively short thymoglobulin induction (five doses) with tacrolimus and mycophenolate mofetil can allow early withdrawal in both pancreas-kidney and pancreas-only transplant recipients...

..001) on sequential analysis. CONCLUSIONS: Histologic evidence of acute rejection in the absence of clinical suspicion resulted in significant tubulointerstitial damage to transplanted kidneys and contributed to CAN...

..8%). Patient, kidney, and pancreas survival rates were 95.8%, 92.9%, and 81.5%, respectively. Surgical complications were the leading cause of pancreatic allograft loss in IDDM and ESRD patients submitted to SPK...

..Using simultaneous kidney-pancreas transplantation (SPK) as a model, we showed that brain death significantly increases circulating CCL2 levels in humans...

..CONCLUSION: A short induction with ATG and steroids associated with a chronic therapy with CellCept and tacrolimus is safe and efficient in preventing acute renal rejection in SPK...

..114 micromol/L; p = 0.02). Steroid avoidance and steroid withdrawal 3 months after transplantation are safe and effective regimens for diabetic patients with pancreas-kidney transplants...

..CONCLUSIONS: The alternative 2-dose regimen of daclizumab was as safe and effective as the conventional 5-dose regimen compared to no antibody induction in SKPT patients, but no long-term benefits were noted...

..Use of the en bloc technique is well suited for very small children, as it prevents potential vascular complications...

..No significant difference in long-term outcomes between the two groups was shown, even if in S-SPK group a higher incidence of pancreas graft loss has been reported and it was in part correlated to a higher number of graft thromboses...

..Increased number of RRT modalities used during the ESRD course is associated with worsening of graft and recipient survival...

..The study despite the small number of cases shows a high complication rate after pancreas retransplantation. Nevertheless, pancreatic retransplantation should be considered in selected patients...

..This series indicates that excellent short- and long-term survival can be obtained after SPKTx and this with a low perioperative surgical morbidity...

..ITx is complementary to conservative and other operative methods of treating SBS. Referral and indication criteria need wider dissemination to prevent life-threatening complications of TPN...

..CONCLUSIONS: The results of this study suggest that the limits of donor acceptability continue to evolve as excellent outcomes can be achieved in SKPTs from selected EX DDs...

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..We conclude that old SPK donors should be considered for patients with decreased access to young donor transplants. Prospective evaluation of this practice is needed...

..Combined pancreas and kidney transplantation should be offered to patients with end-stage diabetic nephropathy...

..These findings may prove valuable in the discussion on both safety of induction therapy and recurrent autoimmunity in SPK and islet transplantation...

..The aim of this study was to determine the impact of the MS on outcomes in simultaneous kidney-pancreas transplantation (SKPT)...

..6%. The results of this work add further evidence that SPK is the gold standard therapy for selected patients with end-stage CKD due to DM 1...

Simultaneous kidney and pancreas transplantation (SKPT) is the treatment of choice for a majority of type I diabetic patients with end-stage renal disease...

..018 at 8 years). CONCLUSION: The addition of pancreatic transplantation prolongs life in type 1 diabetic patients with renal failure compared with renal transplantation alone...

..However, 1-year pancreas and kidney graft function did not differ significantly between the groups...

..CONCLUSIONS: Converting to cyclosporine from tacrolimus was associated with an increased risk of acute rejection especially within the first 30 days post conversion...

..METHODS: starting our program of pancreas transplantation we adopted a technique for "in situ" simultaneous recovery of pancreas, liver and small bowel ..

..001). CONCLUSIONS: This retrospective clinical evaluation confirms that combined pancreas and kidney transplantation should be the first choice to insulin-dependent diabetes mellitus (IDDM) patients with end-stage diabetic nephropathy...

..Patient, kidney, and pancreas graft survival rates at 1 year after simultaneous kidney-pancreas transplantation were 95%, 95%, 85%, for BD group and 90%, 85%, 85% for ED group, respectively...